How did you get insurance to cover your MM CGMS?

[s0ccerfreak]

just wondering how you got insurance to cover your MM CGMS? we are currently trying to get our insurance to cover one

[payam7777777]

Our First Insurance Covered Sensor Order
http://forums.childrenwithdiabetes.com/showthread.php?t=3032&page=2

We got insurance coverage for Dexcom!!
http://forums.childrenwithdiabetes.com/showthread.php?t=2768

Getting Insurance Company Approval
http://forums.childrenwithdiabetes.com/showthread.php?t=3008

Getting over the hurdle of Doctor approval
http://forums.childrenwithdiabetes.com/showthread.php?t=2994

[payam7777777]

Insurance Coverage Issues, ADA resource page
http://www.diabetes.org/advocacy-and-legalresources/healthcare/insurance.jsp

Insurance Coverage by State
http://www.diabetes.org/advocacy-and-legalresources/state-legislation/healthinsurance.jsp

Specific Insurance Info by State
http://www.ncsl.org/programs/health/diabetes.htm

Medicare Coverage of Pumps
http://www.insulin-pumpers.org/howto/medicare.shtml

Pre-existing Conditions & Health Insurance Portability
http://www.ahrq.gov/consumer/hlthpln1.htm#pre-existing

13 things your health insurer doesn't want you to know
http://www.insure.com/health/nottoknow.html

www.kff.org/consumerguide
http://www.kff.org/consumerguide/
This site has some good material on how to file an appeal with your insurance company and an appeal outside your insurance company if that has failed.

[Andrews mom]

We have BCBS and they now have it right in their policy book about the CGMS and they will pay for it as "durable medical equipment".
We have ours on order! :)

[MLH]

I had to get them to assign me a case manager with a medical background. Once that happened I faxed her a letter of med. necessity. Be sure to have the dr put how often your child checks and how you still have undetected lows. My minimed rep sent me articles about the FDA approval. Finally, I had my daughter write her own letter as to why she wanted a cgms. Once they had all this they approved it. The hardest part was getting the case manager. I had to really fight just to speak to a supervisor.

I hope this helps. Good Luck and keep us posted.:cwds:
Michele mom of
AGH 9 dx'd 5 pumper and
LMH 6, nonD